Caffeine and Kids

For better or worse, we are moving from a culture of soda drinkers to coffee drinkers, and our kids are following us. Unfortunately, caffeine and kids do not necessarily go well together.

When I was younger, I was much more sensitive to caffeine than I am now. I used to drive my parents crazy if I had a Coca-Cola after lunch because I would have a lot of difficulty falling asleep at night. Specifically, I would feel like I had “too much energy in my legs”. It wasn’t until I was studying for my Sleep Medicine Boards that I realized that this is a common description of restless leg syndrome in children. One night, in college, I had a late evening iced espresso and could not sleep all night. At that point, I gave up all caffeine until my third year of medical school because I was so annoyed. Now I have a cup or two of coffee a day. To be frank, I need it.

There seem to be more and more ways for kids to get caffeine these days. A company has produced an inhaled form of caffeine inhaler called the Aeroshot. Although the manufacturer has said that it is not recommended for children under 18, the FDA recently issued a warning letter to the manufacturer about the marketing program. The FDA, however, does not have recommendations about caffeine intake for children.

I always ask about caffeine intake in Sleep Clinic. Interestingly, in the group of patients seen in clinic, who have already tried to address their own issues, use is relatively low. However, the statistics about use tell a different story.

In children 5-12 years of age, a study of over 200 children showed caffeine use to be significant in children aged 5-12 years of age. Children 5-7 years old consumed 52 mg daily on average, the equivalent of one can of cola. Children 8-12 consumed about twice that. The more caffeine consumed, the less the children slept at night. Interestingly, the authors reported no increase in enuresis (bedwetting); this had been previously reported due to the fact that caffeine increases urine production.

Caffeine can play into the vicious cycle of adolescent sleep, whereby sleepy teens use caffeine to stay awake, but as a result can’t fall asleep, perpetuating the cycle. Three hundred and nineteen children (ages 10-17) were studied as part of the TuCASA study of adolescent sleep. Screen time, caffeine intake and increasing age in kids were associated with decreased sleep, which in turn was associated with increased weight. Earlier I wrote about the association between inadequate sleep and obesity. The majority of children and teens consume caffeine via high calorie drinks such as sodas, energy drinks, and coffee. It stands to reason that reducing intake of these beverages may reduce obesity by both reducing calorie consumption and improving sleep will likely help maintain a healthy weight, as the accompanying editorial pointed out.

No children under 12 should have caffeine containing beverages routinely.

It is a good rule of thumb to avoid soda entirely.

Older children and teenagers should have it in moderation and avoid consuming it 3-4 hours before bedtime.

For my patients with sleep disorders, I recommend no caffeine after 2 PM.

The exception to the rule is in the case of drowsy driving. If a teenager is drowsy and has to drive somewhere, a brief nap and a caffeinated beverage are the only methods recommended to improve alertness.

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Comments

What fantastic information! My son is a year old and he has only had milk and water to drink. He also drinks strained chicken and kale soup broth that I make once in a while. We are very cautious to give him ANY juice (because of the sugar), even diluted. We probably won’t start that until he’s much older.

I know a couple of moms that allow their infants and toddlers to drink hot chocolate (from Starbucks), a sip of coffee, and even gulps of soda! And then can’t imagine why their kids don’t go to bed until 11:30/midnight. I really don’t understand this as there is so much valuable information (like your post) that proves caffeine is not a good idea or should be limited.

I have a 2 year old and have enjoyed reading your articles for the past couple of years. I’m also a school social worker, and I’ve decided to write a column in our newsletter about promoting healthy sleep in kids. It will be short (probably bullet points). If I emailed it to you would you be willing to look it over for any glaring errors or omissions? I’ll probably do it next week. Thanks!

First and foremost, we respect parents’ role in guiding their children’s choices, including caffeine intake. Second, with regard to energy drinks, these beverages are neither intended nor recommended for children – and an advisory statement on product packaging makes this clear. In addition, energy drink makers also have voluntarily pledged not to market these products to children or sell them in K-12 schools. This, among other actions, is a clear indication that the industry is committed to ensuring that these products are marketed responsibly to the audiences for whom they are intended.
-American Beverage Association